Head and Neck Cancer: The Importance of Prehabilitation

We know about rehabilitation, the act of restoring function following an illness or injury, but what about prehabilitation? Thousands of people in the United States will be diagnosed with head and neck cancer this year. This type of cancer is often found in the oral cavity or pharynx (throat). Just like many other cancers, chemotherapy and radiation are often primary methods of life-saving treatment measures. As a side effect of treatment, many experience a swallowing impairment called dysphagia as a result of a stiffening of the muscles involved in swallowing. Dysphagia has a negative impact on a person's quality of life as well as overall health and nutritional status. Recent literature on this topic has included a discussion related to the idea of “prehabilitation,” which includes preventive speech pathology services prior to or concurrent to the completion of cancer treatment.

Prehabilitation can include:

• Extensive patient education
• Monitoring of swallow function throughout treatment
• Diet modification as needed to maintain swallow safety and prevent aspiration (food or drink entering the airway)
• An exercise program to support maintenance of the range of motion of the jaw and muscles involved in swallowing.

Preventive treatment is associated with maximizing long-term function and reducing the severity of anticipated future impairment, however is underutilized in current practice. Including speech pathology services early-on in your plan of care can significantly reduce negative impacts on functional outcomes and overall quality of life. Talk to your care team to help you determine if prehabilitation is a good fit for you. 

Jenna Randolph, M.A., C.C.C.-S.L.P., is a speech-language pathologist at MyMichigan Medical Center Alma.